Despite a call by researchers for estimates of the treatment clinical and cost effectiveness for relational problems, very little has been done to answer this call. The present study is an examination of actual treatment costs and recidivism rates for patients treated for a relational problem (either in individual or conjoint therapy sessions) in the CIGNA network. Despite the fact that this study compares treatment provider cost-effectiveness for treating relational problems, analyses do not control for average amounts paid by provider license type. Policymakers and third-party payers may use such clinical-effectiveness and cost-effectiveness data to make decisions regarding treatment of relational problems and funding allocation. The present study is also the first to compare the costs of couples therapy versus family therapy for relational problems.

This study examined the cost effectiveness of treating Anorexia Nervosa, Bulimia Nervosa, and Eating Disorder Not Otherwise Specified (NOS), as well as the effects that modality of therapy (i.e. individual, family, and mixed therapy), license of therapist, and secondary diagnosis had on recidivism and total cost of treatment in the care of these patients. One-thousand and thirty-eight patients (56 males, 982 females) diagnosed with Anorexia Nervosa, 1,674 patients (56 males, 1,618 females) diagnosed with Bulimia Nervosa, and 1,997 patients (197 males, 1,800 females) diagnosed with Eating Disorder NOS were included in this study. Results revealed that family therapy was the least expensive form of therapy in average total cost of therapy. Individuals who had family therapy were 3.3 times less likely to recidivate than those who had individual therapy and 7.5 times less likely to recidivate than those who had mixed therapy. Having a secondary diagnosis on average increased the total cost of treatment by $437.34, irrespective of the type of secondary diagnosis (i.e. depression, anxiety, or substance-abuse). These findings suggest that modality of therapy should be considered in the treatment of Anorexia Nervosa, Bulimia Nervosa, and Eating Disorder NOS. Future research should examine the effects of treatment for individuals with a secondary diagnosis.

This study examined the costs of pervasive developmental disorder (PDD) treatment in a large healthcare organization. When compared to individual therapy and mixed therapy, family therapy had significantly fewer sessions, fewer episodes of care, and better cost-effectiveness. Individual therapy had significantly shorter treatment length than mixed therapy. There were no differences in treatment length or number of episodes by license, but dropout and cost-effectiveness were significantly different. Medical doctors had the highest dropout and best cost-effectiveness, while Marriage and Family Therapists had the lowest dropout and Masters of Social Work had the poorest cost-effectiveness. Children had significantly higher dropout than other age groups. An autism diagnosis was associated with fewer sessions but additional episodes of care when compared to PDD. Having a comorbid diagnosis is associated with longer treatment length but slightly fewer episodes of care. A regression model to predict number of episodes of care by intensity of treatment, provider type, and modality, intensity of treatment explained only 6% of the variance.

This study examined the treatment outcomes for Oppositional Defiant Disorder by provider license type and therapy modality. Administrative data from Cigna Insurance Company for 9,904 ODD cases were analyzed to determine the cost, number of sessions, dropout rates, and recidivism rates for treatment of ODD. Descriptive statistics indicate that the mean cost of treatment for ODD across all professions is $389.83. Analyses revealed significant differences in total cost by profession, as well as cost per session for different license types with counselors providing therapy for the lowest average total cost, followed by MFTs, MSWs, Psychologists and then MDs. Chi square analyses revealed that in the treatment of Oppositional Defiant Disorder, MFTs have the lowest drop-out rate, followed by MSWs, then Counselors and Psychologists together, with MDs having the highest proportion of client drop-out. Results on re-admission rates rank MFTs with the lowest proportion of clients returning to care, followed by MDs, Counselors, MSWs, with Psychologists having the highest re-admission rate. When comparing outcomes by therapy modality, results of ANOVA tests indicate that family therapy is most cost-effective followed by individual, then mixed therapy modalities. Family therapy also had significantly fewer sessions than the other modalities.

M. S.

The main purpose of Total Maximum Daily Loads (TMDL) is to achieve a water quality standard. The economic costs of reducing nutrient loadings are often not taken into account during development. In this study, sector targeting is used to minimize the total cost of nutrient reduction by targeting sectors with lower costs per unit of pollution reduction. This study focuses on targeting nitrogen (N) and phosphorus (P) loading reductions from three sectors: agricultural, point source, and urban non-point source, in the North Fork watershed. Linear programming optimization models were created to determine an optimal solution that minimized total compliance cost to implement BMPs subject to targeted loading reductions in N and P in the watershed. The optimal solution for each sector using uniform allocation and sector targeting were compared for N and P loading reductions separately and N and P reductions simultaneously. The difference between sector targeting and uniform allocation showed the sector targeting was the more cost effective approach to achieve the desired nutrient reduction compared to uniform allocation. From the agricultural sector, cropland and hayland buffers provided the best options for reducing both N and P. Urban BMPs are least efficient in term of nutrient reduction and cost. Similarly, for point source upgrade, Broadway has the lowest cost of upgrade per unit of N or P reduction. This study implies that both stakeholders and policymakers can use targeting to achieve nutrient reduction goals at lower costs. The policymakers can incorporate economic considerations in the TMDL planning process which can help in developing a cost-effective tributary strategy and cost-share program. / Master of Science

Energy utilization issues are becoming increasingly important around the world. Existing residential and building service sectors represent a large part of total energy utilization, and the corresponding operational costs and environmental impacts are high. Retrofitting is considered an effective way to accelerate the sustainable transformation of the existing building stock. In Sweden, 1945–1975 was a boom period for the construction of residential buildings. After 40–70 years of use, large contingents of buildings need to be systematically retrofitted. In the past, most Swedish buildings were retrofitted individually, and occasionally in small clusters. Cost-effective retrofitting for large-scale implementation has not yet been substantially attained. Standardizing and industrializing the retrofitting process is expected to produce the following benefits: availability of standardized toolkits based on building typologies; simplified and more efficient decision-making process; lower retrofitting costs; shorter project durations; greater resource-efficiency; lower environmental impact; and higher profitability.The overall aim of the present study is to contribute to the knowledge regarding industrialized retrofitting toolkits in Swedish residential buildings and evaluate the various toolkits. More specifically, the study aims to analyze the energy demand saving potential of different retrofitting measures and long-term profits based on the typology of residential buildings. Based on a systematic set of building properties and classification of existing residential types in Sweden, four slab houses (lamellhus) were selected as the major sub-types of building stock for the demonstration cases. The case buildings were constructed between 1945 and 1975 and are currently used as single-family houses, multi-family houses, or apartment blocks. The main approaches applied to model the retrofitting profits were Consolis Energy +, parametric-based sensitivity analysis, and life-cycle-based economic assessment.Based on the theoretical modeling and analytical results from the case studies, it was found that the energy-saving potential is strongly dominated by the building type, which affects the design of retrofitting toolkits and defines life cycle costs. The results show that improving the efficiency of heat recovery in exhaust ventilation systems is an effective retrofitting measure for energy demand savings in the studied building types. However, the efficiency of other measures is highly dependent on the typology of the buildings. From an economic perspective, toolkits that include all of the possible retrofitting measures may not lead to larger expected reduction in LCC compared to standard retrofits that only include the most sensitive parameters. In addition, the impacts of energy price changes to the LCC in the future are highly diverse in different types of residential buildings. Developing systematic retrofitting guidelines for Swedish residential buildings requires both further research and a close collaboration between all stakeholders involved in the retrofitting process. / <p>QC 20131118</p>

The essay aims to empirically examine which public administration values that are used when recruiting municipal directors, with a focus on whether job advertisements contain a comprehensive picture of this important public mission, which can contribute to suitable people applying for this type of position. The purpose is limited to the following questions, which we intend to construct a theoretical framework around in order to be able to answer at a later stage: • Which public values are prominent in job advertisements for the recruitment of municipal directors and which values appear to a limited extent or not at all? • How are public values formulated in job advertisements for municipal directors in the form of word choice and reasoning? • What does the process look like in the creation of job advertisements for municipal directors? Recruiting well in terms of presenting from the beginning a comprehensive picture of the values and tasks of the position is important; especially in public administrations as employment affects the social-, political-, and economic parts of society. The issue of recruitment becomes interesting, as we can study to what extent democratic and economic values that managers need to relate to emerge already in the initial phase of recruitment. The municipal director becomes particularly relevant because he/she works in an organization that manages several welfare services within a broad spectrum with a large turnover. Through an empirical analysis of a quantitative and qualitative nature of job advertisements and e-mail interviews, we can conclude that it is economic values that primarily appear in the job advertisements. The descriptive study has managed to produce data which indicates that there is a local variation of values, that the complexity of the role does not emerge, it focuses to a large extent on economic values. This data may be useful for future studies that may conceivably investigate potential institutional change in public management or if party affiliation affects the content of the advertisement.

No description available.

No description available.